scholarly journals Addressing the challenges and relational aspects of index-linked HIV testing for children and adolescents: insights from the B-GAP study in Zimbabwe

2020 ◽  
Author(s):  
Chido Dziva Chikwari ◽  
Sarah Bernays ◽  
Stefanie Dringus ◽  
Victoria Simms ◽  
Helen A Weiss ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Children And Adolescents ◽  
Negative Impact ◽  
Discrete Event ◽  
Routine Care ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Community Based ◽  
Testing Uptake ◽  
Sexual Contacts

Abstract Introduction Index-linked HIV testing, targeted at sexual contacts or children of individuals with HIV, may improve yield and efficiency. The B-GAP study evaluated index-linked testing approaches in health facility and community-based settings. This paper reports on a qualitative study to understand factors that affect uptake of index-linked HIV testing for children and adolescents. Methods We conducted four focus group discussions (FGDs) with caregivers who had their children tested through B-GAP and one FGD with providers who offered index-linked HIV testing to indexes. We aimed to understand enabling and inhibiting factors in the decision-making process. Translated and transcribed transcripts were read for familiarisation. Following initial coding, analytical memos were written to identify emerging key themes across the data. Results Our findings showed there was inadequate emphasis on paediatric HIV in routine care which had a negative impact on subsequent uptake of testing for children. Once the decision to test had been made, access to facilities was sometimes challenging, and alleviated by community-based testing. A key finding was that HIV testing is not a discrete event but a process that was influenced by relationships with other family members and children themselves. These relationships raised complex issues that could prevent or delay the testing process. Conclusion There is a need to improve messaging on the importance of HIV testing for children and adolescents and to provide support to caregivers and their families in order to improve testing uptake. Addressing access barriers through the provision of community-based testing and implementing a family centred approach can optimize index-linked testing.

scholarly journals Addressing the challenges and relational aspects of index-linked HIV testing for children and adolescents: insights from the B-GAP study in Zimbabwe

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Chido Dziva Chikwari ◽  
Sarah Bernays ◽  
Stefanie Dringus ◽  
Victoria Simms ◽  
Helen A. Weiss ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Children And Adolescents ◽  
Negative Impact ◽  
Discrete Event ◽  
Routine Care ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Community Based ◽  
Testing Uptake ◽  
Sexual Contacts

Abstract Introduction Index-linked HIV testing, targeted at sexual contacts or children of individuals with HIV, may improve yield and efficiency. The B-GAP study evaluated index-linked testing approaches in health facility and community-based settings. This paper reports on a qualitative study to understand factors that affect uptake of index-linked HIV testing for children and adolescents. Methods We conducted four focus group discussions (FGDs) with caregivers who had their children tested through B-GAP and one FGD with providers who offered index-linked HIV testing to indexes. We aimed to understand enabling and inhibiting factors in the decision-making process. Translated and transcribed transcripts were read for familiarisation. Following initial coding, analytical memos were written to identify emerging key themes across the data. Results Our findings showed there was inadequate emphasis on paediatric HIV in routine care which had a negative impact on subsequent uptake of testing for children. Once the decision to test had been made, access to facilities was sometimes challenging and alleviated by community-based testing. A key finding was that HIV testing is not a discrete event but a process that was influenced by relationships with other family members and children themselves. These relationships raised complex issues that could prevent or delay the testing process. Conclusion There is a need to improve messaging on the importance of HIV testing for children and adolescents and to provide support to caregivers and their families in order to improve testing uptake. Addressing access barriers through the provision of community-based testing and implementing a family-centred approach can optimise index-linked testing.

scholarly journals Addressing the challenges and relational aspects of index-linked HIV testing for children and adolescents: insights from the B-GAP study in Zimbabwe

2020 ◽  
Author(s):  
Chido Dziva Chikwari ◽  
Sarah Bernays ◽  
Stefanie Dringus ◽  
Victoria Simms ◽  
Helen A Weiss ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Children And Adolescents ◽  
Discrete Event ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Community Based ◽  
Paediatric Hiv ◽  
Adequate Knowledge ◽  
Testing Uptake ◽  
Sexual Contacts

Abstract Introduction Index-linked HIV testing, targeted at sexual contacts or children of individuals with HIV, may improve yield and efficiency. The B-GAP study evaluated index-linked testing approaches in health facility and community-based settings. This paper reports on a qualitative study to understand factors that affect index-linked HIV testing for children and adolescents. Methods We conducted four focus group discussions (FGDs) with caregivers who had their children tested through B-GAP and one FGD with providers who offered index-linked HIV testing to indexes. We aimed to understand enabling and inhibiting factors in the decision-making process. Translated and transcribed transcripts were read for familiarisation. Following initial coding, analytical memos were written to identify emerging key themes across the data.Results Caregivers did not have adequate knowledge about the need for, and importance of, paediatric HIV testing. Once the decision to test had been made, access to facilities was sometimes challenging, and alleviated by community-based testing. A key finding was that HIV testing is not a discrete event but a process that was influenced by relationships with other family members and children themselves. These relationships raised complex issues that could prevent or delay the testing process. Conclusion There is a need to improve paediatric HIV literacy and to provide support to caregivers and their families in order to improve testing uptake. Addressing access barriers through the provision of community-based testing and implementing a family centred approach can optimize index-linked testing.

scholarly journals Addressing the Challenges and Relational Aspects of Index-Linked HIV Testing for Children and Adolescents: Insights from the B-GAP Study in Zimbabwe

2020 ◽  
Author(s):  
Chido Dziva Chikwari ◽  
Sarah Bernays ◽  
Stefanie Dringus ◽  
Victoria Simms ◽  
Helen A Weiss ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Children And Adolescents ◽  
Discrete Event ◽  
World Health ◽  
Hiv Care ◽  
Community Based ◽  
Paediatric Hiv ◽  
Adequate Knowledge ◽  
Testing Uptake ◽  
Health Organization

Abstract Introduction Index-linked HIV testing, targeted at sexual contacts or children of individuals with HIV, may improve yield and efficiency. The B-GAP study evaluated index-linked testing approaches in health facility and community-based settings. This paper reports on a qualitative study to understand factors that affect index-linked HIV testing for children and adolescents. Methods We conducted four focus group discussions (FGDs) with caregivers who had their children tested through B-GAP and one FGD with providers who offered index-linked HIV testing to indexes. We aimed to understand enabling and inhibiting factors in the decision-making process. Translated and transcribed transcripts were read for familiarisation. Following initial coding, analytical memos were written to identify emerging key themes across the data.Results Caregivers did not have adequate knowledge about the need for, and importance of, paediatric HIV testing. Once the decision to test had been made, access to facilities was sometimes challenging, and alleviated by community-based testing. A key finding was that HIV testing is not a discrete event but a process that was influenced by relationships with other family members and children themselves. These relationships raised complex issues that could prevent or delay the testing process. Conclusion There is a need to improve paediatric HIV literacy and to provide support to caregivers and their families in order to improve testing uptake. Addressing access barriers through the provision of community-based testing and implementing a family centred approach can optimize index-linked testing. Contributions to the literature • Although promoted and recommended by the World Health Organization; index-linked HIV testing for children has not been standard practice in routine HIV care for many countries including Zimbabwe.• Prior this study, no study has evaluated the factors that influence and affect uptake of index-linked HIV testing for children and adolescents as reported in our manuscript. • Our findings have the potential to bridge the HIV testing gap for children and optimize index-linked testing, a strategy that has been shown to result in higher yield of HIV when compared to universal testing but where uptake remains suboptimal.

scholarly journals Addressing the Challenges and Relational Aspects of Index-Linked HIV testing for Children and Adolescents: Insights From The B-GAP Study in Zimbabwe

2020 ◽  
Author(s):  
Chido Dziva Chikwari ◽  
Sarah Bernays ◽  
Stefanie Dringus ◽  
Victoria Simms ◽  
Helen A Weiss ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Children And Adolescents ◽  
Discrete Event ◽  
World Health ◽  
Hiv Care ◽  
Community Based ◽  
Paediatric Hiv ◽  
Adequate Knowledge ◽  
Testing Uptake ◽  
Health Organization

Abstract Introduction Index-linked HIV testing, targeted at sexual contacts or children of individuals with HIV, may improve yield and efficiency. The B-GAP study evaluated index-linked testing approaches in health facility and community-based settings. This paper reports on a qualitative study to understand factors that affect index-linked HIV testing for children and adolescents.Methods We conducted four focus group discussions (FGDs) with caregivers who had their children tested through B-GAP and one FGD with providers who offered index-linked HIV testing to indexes. We aimed to understand enabling and inhibiting factors in the decision-making process. Translated and transcribed transcripts were read for familiarisation. Following initial coding, analytical memos were written to identify emerging key themes across the data.Results Caregivers did not have adequate knowledge about the need for, and importance of, paediatric HIV testing. Once the decision to test had been made, access to facilities was sometimes challenging, and alleviated by community-based testing. A key finding was that HIV testing is not a discrete event but a process that was influenced by relationships with other family members and children themselves. These relationships raised complex issues that could prevent or delay the testing process. Conclusion There is a need to improve paediatric HIV literacy and to provide support to caregivers and their families in order to improve testing uptake. Addressing access barriers through the provision of community-based testing and implementing a family centred approach can optimize index-linked testing. Contributions to the literature • Although promoted and recommended by the World Health Organization; index-linked HIV testing for children has not been standard practice in routine HIV care for many countries including Zimbabwe.• Prior this study, no study has evaluated the factors that influence and affect uptake of index-linked HIV testing for children and adolescents as reported in our manuscript. • Our findings have the potential to bridge the HIV testing gap for children and optimize index-linked testing, a strategy that has been shown to result in higher yield of HIV when compared to universal testing but where uptake remains suboptimal.

USING LAY COUNSELLORS TO PROMOTE COMMUNITY-BASED VOLUNTARY COUNSELLING AND HIV TESTING IN RURAL NORTHERN GHANA: A BASELINE SURVEY ON COMMUNITY ACCEPTANCE AND STIGMA

2007 ◽  
Vol 39 (5) ◽  
pp. 721-733 ◽  
Author(s):  
F. BAIDEN ◽  
G. AKANLU ◽  
A. HODGSON ◽  
P. AKWEONGO ◽  
C. DEBPUUR ◽  
...  
Keyword(s):  
Focus Group ◽  
Hiv Testing ◽  
Northern Ghana ◽  
Baseline Survey ◽  
People Living With Hiv ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Community Based ◽  
Voluntary Counselling ◽  
Hiv Aids

SummaryAccess to voluntary counselling and HIV testing (VCT) remains limited in most parts of Ghana with rural populations being the least served. Services remain facility-based and employ the use of an ever-dwindling number of health workers as counsellors. This study assessed approval for the use of lay counsellors to promote community-based voluntary counselling and testing for HIV and the extent of HIV/AIDS-related stigma in the Kassena-Nankana district of rural northern Ghana. A cross-sectional questionnaire survey was conducted. Logistic regression was used to identify predictors of the tendency to stigmatize people living with HIV/AIDS (PLWHAs). Focus group discussions were held and analytical coding of the data performed. The majority (91·1%) of the 403 respondents indicated a desire to know their HIV status. Most (88·1%) respondents considered locations outside of the health facility as preferred places for VCT. The majority (98·7%) of respondents approved the use of lay counsellors. About a quarter (24%) of respondents believed that it was possible to acquire HIV through sharing a drinking cup with a PLWHA. About half (52·1%) of the respondents considered that a teacher with HIV/AIDS should not be allowed to teach, while 77·2% would not buy vegetables from a PLWHA. Respondents who believed that sharing a drinking cup with a PLWHA could transmit HIV infection (OR 2·50, 95%CI 1·52–4·11) and respondents without formal education (OR 2·94, 95%CI 1·38–6·27) were more likely to stigmatize PLWHAs. In contrast, respondents with knowledge of the availability of antiretroviral (ARV) drugs were less likely to do so (OR 0·40, 95%CI 0·22–0·73). Findings from the thirteen focus group discussions reinforced approval for community-based VCT and lay counsellors but revealed concerns about stigma and confidentiality. In conclusion, community-based VCT and the use of lay counsellors may be acceptable options for promoting access. Interventional studies are required to assess feasibility and cost-effectiveness.

scholarly journals Drivers and barriers to workplace-based HIV self-testing among high-risk men in Uganda: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Patience A. Muwanguzi ◽  
Robert C. Bollinger ◽  
Stuart C. Ray ◽  
LaRon E. Nelson ◽  
Noah Kiwanuka ◽  
...  
Keyword(s):  
Focus Group ◽  
Hiv Testing ◽  
Private Security ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Private Security Companies ◽  
Self Testing ◽  
Key Informant ◽  
Hiv Testing Services ◽  
Security Companies

Abstract Background Men in Sub-Saharan Africa are less engaged than women in accessing HIV testing and treatment and, consequently, experience higher HIV-related mortality. Reaching men with HIV testing services is challenging, thus, increasing the need for innovative ways to engage men with low access and those at higher risk. In this study, we explore men’s perceptions of drivers and barriers of workplace-based HIV self-testing in Uganda. Methods An exploratory study involving men working in private security companies employing more than 50 men in two districts, in central and western Uganda. Focus group discussions and key informant interviews were conducted. Data were analyzed using inductive content analysis. Results Forty-eight (48) men from eight private security companies participated in 5 focus group discussions and 17 key informant interviews. Of the 48 men, 14(29.2%) were ages 26–35 years. The majority 31(64.6%) were security guards. The drivers reported for workplace-based HIV self-testing included convenience, autonomy, positive influence from work colleagues, the need for alternative access for HIV testing services, incentives, and involvement of employers. The barriers reported were the prohibitive cost of HIV tests, stigma, lack of testing support, the fear of discrimination and isolation, and concerns around decreased work productivity in the event of a reactive self-test. Conclusions We recommend the involvement of employers in workplace-based HIV self-testing to encourage participation by employees. There is need for HIV self-testing support both during and after the testing process. Both employers and employees recommend the use of non-monetary incentives, and regular training about HIV self-testing to increase the uptake and acceptability of HIV testing services at the workplace.

scholarly journals Setting the global research agenda for community-based HIV service delivery through the faith sector

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Martha T. Ndlovu-Teijema ◽  
Maarten O. Kok ◽  
Sabine L. van Elsland ◽  
Hilleen Smeets ◽  
David Barstow ◽  
...  
Keyword(s):  
South Africa ◽  
Focus Group ◽  
Research Agenda ◽  
Primary Research ◽  
Focus Group Discussions ◽  
Online Questionnaire ◽  
Group Discussions ◽  
Community Based ◽  
Faith Leaders ◽  
Global Research

Abstract Background While leading AIDS organizations expect faith and health collaborations to play a crucial role in organizing and scaling up community-based HIV services, it is unclear how this can be realized. Little primary research has been conducted into which strategies for collaboration and service provision are most effective, efficient, scalable and sustainable. Seeking to align research with urgent needs, enhance coordination and increase the likelihood that results are used, this study aimed to set an inclusive global research agenda that reflects priority research questions from key stakeholders at the intersection of HIV healthcare and faith. Methods In order to develop this global research agenda, we drew from document analyses, focus group discussions, interviews with purposively selected key informants from all continents (policy-makers, healthcare providers, faith leaders, academics and HIV activists), an online questionnaire, and expert meetings at several global conferences. We carried out focus group discussions and interviews with faith leaders in South Africa. Other stakeholder focus groups and interviews were carried out online or in person in France, Switzerland, the Netherlands and South Africa, and virtual questionnaires were distributed to stakeholders worldwide. Respondents were purposively sampled. Results We interviewed 53 participants, and 110 stakeholders responded to the online questionnaire. The participants worked in 54 countries, with the majority having research experience (84%), experience with policy processes (73%) and/or experience as a healthcare provider (60%) and identifying as religious (79%). From interviews (N = 53) and questionnaires (N = 110), we identified 10 research themes: addressing sexuality, stigma, supporting specific populations, counselling and disclosure, agenda-setting, mobilizing and organizing funding, evaluating faith-health collaborations, advantage of faith initiatives, gender roles, and education. Respondents emphasized the need for more primary research and prioritized two themes: improving the engagement of faith communities in addressing sexuality and tackling stigma. Conclusions A wide range of respondents participated in developing the research agenda. To align research to the prioritized themes and ensure that results are used, it is essential to further engage key users, funders, researchers and other stakeholders, strengthen the capacity for locally embedded research and research uptake and contextualize priorities to diverse religious traditions, key populations and local circumstances.

scholarly journals Socio-economic Status and Associated Factors in the Uptake of HIV Testing: Findings from the South African Population-based National Household Survey Conducted in 2017

2020 ◽  
Author(s):  
Sean Jooste ◽  
Musawenkosi Mabaso ◽  
Myra Taylor ◽  
Alicia North ◽  
Yolande Shean ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Perceived Risk ◽  
Negative Impact ◽  
Economic Status ◽  
Household Survey ◽  
Population Based ◽  
Hiv Treatment ◽  
Cluster Sampling ◽  
Cross Sectional ◽  
Testing Uptake

Abstract Background: Improved understanding of barriers to HIV testing is important for reaching the first of the UNAIDS 90-90-90 targets, which states that 90 percent of HIV positive individuals ought to know their HIV status. This study examined socioeconomic status (SES) factors and related covariates associated with HIV testing uptake in the general population in South Africa. Information on SES and HIV testing may impact the HIV treatment and care cascade and prevention of HIV transmission. Methods: This study used data obtained from a national cross-sectional, population-based household survey conducted in 2017 using a multi-stage stratified random cluster sampling design. A composite SES score was created using multiple correspondence analyses of household assets; households were classified into wealth quintiles and dichotomized into low SES/poorest (lowest 3 quintiles) and high SES/less-poor (highest 2 quintiles). Bivariate and multivariate logistic regression models were fitted to analyse associations between the uptake of HIV testing and a set of socio-demographic and HIV-related variables. Results: HIV testing uptake was 73.8% and 76.7% among low and high SES household, respectively, both of which were below the first 90 target. The findings showed increased uptake of HIV testing was associated with being female and having a higher educational level independent of SES. Decreased uptake of HIV testing was associated with being from White and Indian/Asian race groups, residing in rural formal areas, alcohol consumption, and high self-perceived risk of HIV infection.Conclusions: We found that HIV testing uptake was similar for people from both low and high SES. However, interventions aimed at improving HIV testing in order to reach the first 90 target, should target males, all race groups, those with low education attainment, and those residing in rural formal areas. Reaching the first target will require efforts to improve community knowledge, and awareness about the negative impact of alcohol use and address HIV risk perception.

scholarly journals The Development Of Election Smart House As A Tool Of Political Education Based On Local Wisdom

2019 ◽  
Vol 35 (1) ◽  
pp. 69-77
Author(s):  
Al Rafni ◽  
Suryanef Suryanef
Keyword(s):  
Lesson Plan ◽  
Political Education ◽  
Research Approach ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Community Based ◽  
Model Research ◽  
Smart House ◽  
Election Commission ◽  
Depth Interviews

Election Smart house that established by the General Election Commission in every province is the innovative effort in providing the facility for political education in society. The problem is RPP has not been used optimally by users and still needs to be institutionalized as a tool of political education based on local wisdom. This paper aims to elaborate on the forms of political education activities, especially voter education contained in the RPP, even how the model for the development of RPP as a tool of political education based on local wisdom. The research approach uses a more intensive qualitative approach through focus group discussions/ FGDs and in-depth interviews. While to build the model, Research and Development (R & D) are used. The results of the study show that the political education services contained in the lesson plan need to be developed by standardizing services and supporting facilities that can be a model for political education facilities for the community based on local wisdom.

scholarly journals Community Based Risk Behaviour Study on HIV/AIDS Targeting Women in Nepal - 2007

1970 ◽  
Vol 6 (2) ◽  
pp. 1-10
Author(s):  
KK Jha ◽  
VS Salhotra ◽  
AP Weerakoon ◽  
L Shrestha ◽  
P Malla
Keyword(s):  
High Risk ◽  
Risk Behaviour ◽  
Married Women ◽  
Age Group ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Community Based ◽  
High Risk Sexual Behaviour ◽  
Risk Sexual Behaviour ◽  
Hiv Aids

Nepal has progressed from a HIV low prevalence country to one with a concentrated epidemic in certain subgroups of population. It has been documented that girls and women are more vulnerable to HIV infection. However there is little documented evidence on the risk behaviour among women in Nepal. This study was conducted to assess the pattern of risk behaviour for HIV among women in Nepal. Methodology : The main component of the study comprised a community based cross-sectional study, using a multi stage random sampling technique. Data was collected by trained field health workers using an interviewer administered questionnaire. Eight focus group discussions were also conducted to supplement the findings. Statistical analysis was carried out using SPSS version 13. Results : A significant number of un married (13.7%) women and 2.2% of married women indulged in high risk sexual behaviour. A significant positive association was observed between sexual risk behaviour of married women and monthly family income less than 5000 Nepali Rs ,age group 25-34y and young age group (15- 34) in unmarried women. Nearly 70% of participatory women have heard about AIDS and have satisfactory level of knowledge about HIV/AIDS. However, significant number of respondents had misconceptions that one could contract HIV through hand shaking, mosquito bites and hugging. Using Condoms during unprotected sexual intercourse in both married and unmarried women were low (19.4% and 6.2% respectively). Findings of Focus Group Discussions revealed there is a strong stigma associated with HIV/AIDS in this rural community in Nepal. Conclusions : One in every seven unmarried woman in Nepal indulged in high risk sexual behaviour, which is much more compared to married women. There is an urgent need for reproductive health education especially among teenagers and for the National HIV/AIDS Control Programme to expand its awareness generation activities. Keywords : HIV/AIDS, women, risk behaviour, Nepal DOI: 10.3126/saarctb.v6i2.3051 SAARC J. Tuber. Lung Dis. HIV/AIDS 2009 VI (2) 1-10

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